3/6/12

What Does Abdominal Pain After Coronary Bypass Mean?

Abdominal pain after coronary bypass
surgery can be mild or considerable, and make the patient think something is
wrong. Pain can be frightening, especially after coronary bypass surgery (also
known as CABG).

I consulted with Dr. Michael Fiocco, Chief of Open Heart
Surgery at Union Memorial Hospital, one of the nation's top 50 heart hospitals.

“This is an extremely common problem which in the vast majority of cases is
benign and self-limiting,” says Dr. Fiocco. So then, what are some causes of
post-op pain with coronary bypass surgery?

Dr.
Fiocco continues: “The most common causes are pain from the drains which exit
the body in the upper abdomen, causing some pain and occasional muscle
spasm and constipation.

"The discomfort from the drains subsides when the
drains are removed 48 hours after surgery. Constipation is usually
resolved before discharge, but may linger depending on the patient’s level of
activity and their use of narcotic pain medicine.

"More narcotics, less
activity, means more constipation. These common causes
of abdominal pain rarely last for more than a few days and the pain is usually
quite mild.”

But
if the pain is more than mild, say, approaching a 7 or 8 on the hospital’s pain
scale, where a rating of 10 means the worst pain you can imagine, this may
reflect simply the patient’s general physical condition (is the patient older,
out of shape?); the patient’s natural tolerance for pain; and if other issues
are going on with the patient, such as clinical depression (primary or
secondary), which can amplify perception of pain, and abdominal pain from
coronary bypass surgery is no exception to this amplification.

There
can also be more serious, though much rarer, causes of abdominal pain following
CABG.

Dr. Fiocco explains, “More concerning and fortunately very rare is pain
from pancreatitis, bowel distention, and peptic ulcer disease. These
disorders require longer stays in the hospital and close observation.”

What
would be the course of treatment in the event of these complications following
CABG? “CT scans, upper and/or lower endoscopy, and frequent blood tests are
needed to diagnose and treat these problems,” says Dr. Fiocco. “They are
rarely life threatening, but may be quite debilitating for several weeks.”

Can
abdominal pain following coronary bypass surgery ever mean a life threatening
situation? “The most unusual cause of abdominal pain, but the most dangerous,
is ischemic bowel, or loss of blood supply to the bowel,” says Dr. Fiocco.

“This
occurs secondary to a clot or piece of plaque flowing downstream to the
arteries of the intestine, similar to how a stroke affects the brain.

"This may require emergency surgery in its most severe form. The
most important message for patients is that abdominal pain may occur after
CABG, but is almost always self-limiting, mild, and benign.”

Copyright Notice

All text is copyright property of this site's author. It is illegal to copy, reprint or republish any content on this site without the author's permission. Many of the articles on this site were originally posted, by me, on the Yahoo! Voices site (formerly Associated Content) between 2007 and 2014. That gave other bloggers plenty of time to "borrow" my articles without crediting me, which is why you may notice that some of my treadmill and other fitness articles are the same ones you read elsewhere with a more previous posting date! Yahoo! Voices shut down July 31, 2014, and beginning about a month prior to that, I began reposting all of my articles onto this site.